The primary objective of this study was to investigate the prevalence of coronary risk factors, lifestyle behaviors, and related knowledge, attitudes and beliefs in the offspring of women with documented premature coronary heart disease (CHD). To examine coronary risk factors, we screened a sample of 87 apparently healthy offspring (56 females and 31 males) of women with documented premature CHD. More than half of the offspring had total and LDL cholesterols above the recommended levels for primary prevention, 31% were current smokers, and 56% exercised fewer than 3 times a week. A high proportion were overweight with a high prevalence of central obesity. There were 13% with only one major risk factor, a positive family history of premature CHD, 10% had two risk factors, 23% had three, and 54% had four or more CHD risk factors. When compared to the Framingham cohort, 29% of sons and 30% of daughters exceeded their age- and sex-specific average risk for developing CHD in 1O years. Only 28% identified heredity as a major cause of CHD and 47% perceived their risk for future MI as < others their age. These findings suggest that adult children of women with premature CHD have a high prevalence of modifiable risk factors and do not perceive themselves to be at risk for CHD.